Page 87 - Benefits Summary 2018-2019

Reliance Standard Voluntary Plans

Voluntary Group Term Life Insurance

Premium Table

Plan Holder: Hercules Real Estate Services

Scheduled Benefit: Each eligible employee may elect for himself and/or his eligible spouse an amount of insurance shown in the
Table below.

For employees age 75 and older: Benefit amounts are reduced according to the age-based reduction chart shown in the
Voluntary Term Life brochure. When selecting an amount of insurance, you must select a pre-age 75 benefit amount.

Weekly Premiums
Employee/Spouse Premiums:
To find you and your spouse's premium -
§ Determine your age band: Your age = your age at your last birthday.
§ Select a benefit amount (employees age 75 and older: see above comment - do not select a calculated reduced amount).
§ Spouse premium: Repeat the steps above for your spouse at his/her age at his/her last birthday. Your spouse must be under
age 70 to be enrolled.
Employee and spouse rates change as insured moves from one age bracket to the next.

Rates are subject to change.

Approximate Bi-Weekly Premiums
Benefit Age Age Age Age Age Age Age Age Age Age Age Age
Amount - 19 20 - 24 25 - 29 30 - 34 35 - 39 40 - 44 45 - 49 50 - 54 55 - 59 60 - 64 65 - 69 70+

$10,000 $0.17 $0.17 $0.17 $0.17 $0.25 $0.40 $0.69 $1.15 $1.95 $2.38 $3.55 $6.79
$20,000 $0.34 $0.34 $0.34 $0.34 $0.50 $0.80 $1.38 $2.30 $3.90 $4.76 $7.11 $13.58
$30,000 $0.51 $0.51 $0.51 $0.51 $0.75 $1.20 $2.08 $3.45 $5.86 $7.14 $10.66 $20.37
$40,000 $0.68 $0.68 $0.68 $0.68 $1.00 $1.61 $2.77 $4.60 $7.81 $9.53 $14.22 $27.16
$50,000 $0.85 $0.85 $0.85 $0.85 $1.25 $2.01 $3.46 $5.75 $9.76 $11.91 $17.77 $33.95
$60,000 $1.02 $1.02 $1.02 $1.02 $1.50 $2.41 $4.15 $6.90 $11.71 $14.29 $21.32 $40.74
$70,000 $1.20 $1.20 $1.20 $1.20 $1.74 $2.81 $4.85 $8.04 $13.67 $16.67 $24.88 $47.52
$80,000 $1.37 $1.37 $1.37 $1.37 $1.99 $3.21 $5.54 $9.19 $15.62 $19.05 $28.43 $54.31
$90,000 $1.54 $1.54 $1.54 $1.54 $2.24 $3.61 $6.23 $10.34 $17.57 $21.43 $31.98 $61.10
$100,000 $1.71 $1.71 $1.71 $1.71 $2.49 $4.02 $6.92 $11.49 $19.52 $23.82 $35.54 $67.89